NPI | 1477939478 |
---|---|
Former Name | CHELSEA RAYNA TERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 5176) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1995DT) |
Enumeration Date | 2015-08-03 |
Last Update Date | 2021-09-09 |